Everything You Need to Know About National Insurance Varistha Mediclaim Policy

We often find ourselves struggling with mounting medical expenses due to known or unknown medical conditions as we age. This leads to a stressful situation as we risk draining our savings or retirement fund on the sky-high medical bills. To safeguard your interest, it is important to choose a reliable mediclaim policy, specially crafted for senior citizens of India.

We believe one of the safest ways is to invest in the government-backed National Insurance Varistha Mediclaim policy specifically designed for the senior citizens aged 60 and above. The policy comes loaded with a range of features and benefits that we will be discussing.

Eligibility for the Policy

  • The minimum entry age for the policy is 60 years and the maximum is 80 years
  • The policy is valid for 1 year
  • There is no age restriction for renewal
  • INR 1,00,000 is the cover for hospitalization & domiciliary hospitalization and INR 2,00,000 is the insured sum for critical illness cover (Add-ons)

Features of National Insurance Varistha Mediclaim

  • The sum insured coverage is applicable for emergency or planned hospitalization
  • The health insurance coverage can be extended or renewed for a lifetime
  • If you have been covered with any medical policy continuously for the last 3 years, no health check-up is required
  • During the claim-free years, you can avail a cumulative bonus and a free health check-up

Benefits of National Insurance Varistha Mediclaim

  • Cashless facility in-network hospitals for treatments and reimbursement facility for treatments in non-network hospitals
  • Pre-hospitalization medical coverage of 30 days and post-hospitalization coverage of 60 days is available
  • Optional coverage of INR 2 lakhs for critical illnesses like cancer, multiple sclerosis, stroke, among others, is available under which the insured amount is paid in a lump sum on diagnosis
  • After one year of claim-free renewal, you can opt for the coverage of some pre-existing diseases like hypertension and/or diabetes
  • Paralysis and blindness can be covered under critical illness by paying an extra premium of 15% in each case or 25% in the case of both covers together
  • The reimbursement amount for a medical check-up is limited to 2% of the sum insured
  • A free look period of 15 days is available to experience the policy benefits. If you’re not satisfied, you can opt for a return and refund of the policy
  • Tax benefits can be availed on the premiums under Section 80D of the Income Tax Act, 1961. However, tax laws are subject to change and hence, it is advisable to consult a tax expert before proceeding

Understanding the National Insurance Varisthamediclaim policy Premium Chart

Plan your finances in advance with the help of the below-mentioned Varistha Mediclaim premium chart. You will have to pay the required premium based on the sum insured, type of policy, and your age for this government mediclaim for senior citizens.

Please note, for fresh entrants to the National Insurance-Varistha Mediclaim policy, a 10% additional premium is payable. If you opt for the National Insurance Varistha Mediclaim policy online, you may check the Varisthamediclaim policy premium calculator to get a fair idea of the current applicable rates.

What’s covered in National Insurance Varistha Mediclaim?

  • Domiciliary hospitalization expenses are paid at 1% of sum insured up to the value of 25% of the sum insured
  • Room, boarding expenses up to a defined limit
  • Medical expenses on anesthesia, surgical appliances, blood, oxygen, diagnostic charges, drugs, etc. are covered up to the amount of 50% of the Sum Insured
  • The cost of any surgery, including fees of the surgeon, medical practitioner, consultants, anesthetist, etc. is covered up to the amount of 25% of the sum insured
  • Intensive Care Unit (ICU) expenses are covered up to a specified limit
  • Free health check-up on every 3 claim-free years
  • The emergency requirement for the ambulance is covered to the amount of INR 1000 for one policy year
  • Cataract, Benign Prostatic Hyperplasia, and Organ Transplant are also covered but to a certain specified limit

What Is Not Covered In National Insurance Varistha Mediclaim?

The Varistha Mediclaim offered by National Insurance has an initial waiting period of 30 days in which only accidental injury is covered. Furthermore, the policy has a waiting period of 1 year for the following conditions -

  • Benign prostatic hypertrophy j. Pilonidal sinus
  • Hernia k. Calculus diseases
  • Fissure/Fistula in anus
  • Hysterectomy for menorrhagia or fibromyoma
  • Cataract i. CSOM (Chronic Supportive Otitis Media)
  • Hydrocele l. Benign lumps/growths in any body part
  • Congenital internal disease or surgical treatment of tonsils, adenoids and deviated nasal
  • Septum and related disorders
  • Piles (Haemorrhoids)
  • Joints replacements of any kind, except the ones arising out of an accident
  • Vaccination of any kind
  • Cost of eyeglasses, dental treatment, and surgery
  • Diagnosis expenses where the disease has no prior symptoms
  • Cosmetic medical expenses
  • Any injury or disease as an outcome of a war
  • Self-inflicting injuries by the use of drugs or alcohol
  • Diseases originating from HIV AIDS are not included
  • Any unprescribed Vitamin or tonic intake
  • Diseases caused due to exposure to nuclear weapons or materials
  • Treatment cost outside India

Apart from the above, if the National Insurance Varishtha Mediclaim policyholder smokes more than 40 cigarettes a day, or consumes an equivalent amount of tobacco, he/she shall be excluded from the coverage.

With 6000+ network hospitals and the Incurred Claims Ratio of 114.24% (as per the latest Feb 2020 report), National Insurance Company’s Varistha Mediclaim Policy is an ideal choice for senior citizens with affordable premiums and comprehensive coverage to safeguard themselves from the perils of rising medical care expenses.